Two cases of malignant peritoneal mesothelioma without asbestos exposure: cytologic and immunohistochemical features

Our plain-English summary of Two cases of malignant peritoneal mesothelioma without asbestos exposure: cytologic and immunohistochemical features, by Y. Kinoshita, K. Takasu, T. Yuri, et al (Annals of Diagnostic Pathology, 2013).

The study

• Authors: Y. Kinoshita, K. Takasu, T. Yuri, K. Yoshizawa, N. Uehara, A. Kimura, H. Miki, A. Tsubura, N. Shikata
• Journal: Annals of Diagnostic Pathology
• Published: 2013;17(1):99-103
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Approximately half a century has passed since asbestos was first reported to be the main cause of malignant mesothelioma; yet the incidence of this disease continues to increase worldwide. Twenty percent of cases occur without prior asbestos exposure, and in these patients, malignant peritoneal mesothelioma is more common than malignant pleural mesothelioma. Here, we report the cytomorphologic and immunohistochemical features of 2 cases of malignant peritoneal mesothelioma where there was no history of asbestos exposure. Ascitic cytology showed that most cells were isolated and that clusters were rarely observed, but the findings were consistent with malignant mesothelioma in both cases. Immunohistochemical analysis for epithelial membrane antigen, calretinin, vimentin, β-catenin, melan-A, glucose transporter-1, cytokeratin CAM5.2, Wilms tumor antigen-1, D2-40, CD146, progesterone receptor, estrogen receptor, and cytokeratin 5/6 was indicative of malignant mesothelioma. In malignant mesothelioma without prior asbestos exposure, the etiology and prognostic significance is still unclear. Further study is needed to clarify this point.

Copyright © 2013 Elsevier Inc. All rights reserved.

In plain English

This article was a report of two cases of malignant peritoneal mesothelioma, a cancer of the lining of the abdomen, from Kansai Medical University Takii Hospital in Osaka, Japan. Both patients were men, aged 71 and 70 at diagnosis, who had fluid build-up in the abdomen (ascites). The article's title describes the cases as without asbestos exposure; its results section states that a history of asbestos exposure was not recorded for either patient. They died 25 and 11 months after diagnosis. The authors examined cells in the abdominal fluid using a published scoring system and stained biopsy tissue for a panel of markers. In both cases the fluid cells allowed a diagnosis of malignant peritoneal mesothelioma. In case 2, most cells lay singly rather than in clusters. Tissue from both cases was positive for markers including calretinin, WT-1, D2-40, CD146, beta-catenin and GLUT-1, and negative for CK 5/6, CA125 and estrogen receptor. The authors suggested CD146 and GLUT-1 may be promising mesothelioma markers. They concluded that the cause of mesothelioma in people not exposed to asbestos is not established and that further study is needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of two patients (cytology and immunohistochemistry)
• Who was studied: Two men, aged 71 and 70 at diagnosis, with malignant peritoneal mesothelioma, whose material came from the Division of Pathology at Kansai Medical University (Takii Hospital, Osaka, Japan); dates of diagnosis not given
• Exposure: No asbestos exposure was studied; the article states that neither patient had a recorded history of asbestos exposure. No fiber types, products, jobs or doses are given.
• Main results:
  • Both patients died: survival after diagnosis was 25 months (case 1) and 11 months (case 2)
  • In both cases, examination of cells in the abdominal fluid allowed a diagnosis of malignant peritoneal mesothelioma
  • In case 2, most mesothelioma cells in the fluid were isolated rather than in clusters, against a background mostly of lymphocytes
  • Binucleated cells made up about 11% to 14% of malignant mesothelioma cells across the two cases
  • Tumor tissue from both cases stained positive for EMA, calretinin, vimentin, beta-catenin and GLUT-1 (GLUT-1 marked partly positive in Table 3); WT-1, D2-40, CD146, CK CAM5.2 and melan-A were also positive in both
  • CK 5/6, EA, ERA, CA19-9, CA125 and estrogen receptor were negative in both cases. Progesterone receptor was positive only in a small proportion of tumor cells (less than 1% of tumor tissue) in case 2.
• The authors' conclusion: The authors suggested that CD146 and GLUT-1 may be promising markers for malignant mesothelioma. They concluded that the cause of malignant mesothelioma in people not exposed to asbestos is not established and that further studies are needed.
• Limitations the authors state:
  • The tissue features of case 1 were unclear because only a small amount of tissue had been removed

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Asbestos Exposure, Malignant Mesothelioma, Pleural Mesothelioma, Cytology, Epithelial Membrane Antigen (EMA), Calretinin, CAM5.2.

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